The Disease Management Care Blog agrees these are all good ideas. Here’s why:

Open up any medical-scientific journal and you, along with the majority of other readers, will be tempted to skip past the ‘methods’ section, scan the results and jump right to the conclusions. So will much of the media. However, if the topic is really important to you, your patients or your business, the methods may be the most important art of the mansucript. As a rule of thumb, if the DMCB doesn’t understand the methods section because it is lengthy and littered with complex jargon that involves combined/irrelevant endpoints involving subgroups and strained comparisons, it generaly believes the results are suspect and moves onto the next article. PHII’s recommendations, if carried out, could go a long way toward reassuring readers of CER that complex methods aren’t being used to obscure weaknesses in the conclusions.

As we know, strings are being attached to other sources of Federal funding. If it is good enough for business and finance, it is certainly good enough for health-related research. PHII thinks any researcher should be willing to put their pledge where his or her month is. In fact, PHII is perfect organization to offer such a pledge document.

All the ‘peer review’ medical-scientific journals maintain a bullpen of ‘go to’ clinicians/scientists/researchers who agree to read submitted manuscripts that are being considered for publication. The DMCB has served as a peer reviewer for a number of top flight journals and it can be a tedious task: the writing is seldom polished and the conclusions are often not valid. As a result, it's often up to the peer reviewers to serve as an ‘outsourced’ editorial staff to help correct the English and point out the flaws in the underlying science. Peer reviewers generally agree to do this because its flattering to be asked to do it, breaking information is available before it makes it to print, it makes for good ballast on a CV or resume and sometimes it leads to being asked to write an editorial. However, ultimately, reviewers typically do this on their own dime and some may not give their reviews the attention they deserve. PHII argues its time for the peer review process – and that part of the U.S. economy devoted to health care - to get what it pays for.

As noted in prior posts, the DMCB would go one step further and go ‘open source’ on CER. Publicly funded research should generate publicly available data. Ultimately, anyone should be able to download the data and - assuming they adhere to privacy standards and use deidentified data - keep the original researchers and their conclusions honest. Who knows, they may find something that was missed. If no one can attack the integrity of the original data, the federal sponsors of CER will be that more confident that the conclusions are valid.

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Here's what one reader had to say about the Population Health Blog's ability to to go beyond simple headlines and mainstream newsfeeds:

"This past week, I was surprised to read some of the generic headlines summarizing the VA readmission study. You know, through medical newsfeeds, they almost implied that length of stay didn't have anything to do w/readmissions. When I read the Annals article today, there was certainly a lot more to the study than that. Was happy to see your nice summary, which I agree w/100%. Just wanted to drop you a line to say that Ilooked at your blog w/hopes of finding some commentary on the study---and there it was!"

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“Moving into the next century, the most important breakthroughs will be in the from of clinical process innovation rather than clinical product improvement…the next big advances in health care will be the development of protocols for delivering patient care across health care settings over time.”

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About Jaan Sidorov MD, MHSA, FACP

While his web persona has been described as a "blogvocateur," Dr. Sidorov has wide range of knowledge about the medical home, condition management, population-based health care and managed care that is only exceeded by his modesty. He has been quoted by the Wall Street Journal, Consumer Reports and NPR’s All Things Considered.
He has over 20 years experience in primary care, disease management and population based care coordination. He is a primary care general internist and former Medical Director at Geisinger Health Plan.
He is primary care by training, managed care by experience and population-based care strategies by disposition.
The contents of this blog reflect only the opinions of Sidorov and should not be interpreted to have anything to do with any current or past employers, clients, customers, friends, acquaintances or enemies, personal, professional, foreign or domestic. This is also not intended to function as medical advice. If you really need that, work with a personal physician or call 911 for crying out loud.
Jaan can be reached at jaansATaolDOTcom.